Clinical Nutrition at Huadong Hospital Shanghai | CMCS

China's National Leader in Clinical Nutrition

The Department of Clinical Nutrition at Huadong Hospital — affiliated with Fudan University — is widely recognized as China's premier clinical nutrition center, with a national and international reputation for excellence in enteral and parenteral nutrition, oncology nutrition support, geriatric nutrition, surgical nutrition, critical care nutrition, and the management of complex nutritional disorders. As the founding center of clinical nutrition in China and the home of some of the discipline's most influential pioneers, Huadong Hospital's clinical nutrition department has shaped nutritional practice across China for decades and continues to lead the field in research, education, and clinical innovation. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients requiring specialized nutritional assessment and support at Huadong Hospital.

For international patients with cancer-related malnutrition, post-surgical nutritional needs, inflammatory bowel disease, short bowel syndrome, eating disorders, or complex nutritional requirements — Huadong Hospital's clinical nutrition department offers an unparalleled combination of clinical expertise, research leadership, and multidisciplinary integration.

About the Department

The clinical nutrition department is a national key clinical specialty and national clinical nutrition training center operating a comprehensive outpatient nutrition clinic, a dedicated nutrition support team (NST) providing inpatient consultation across all wards, a metabolic laboratory with indirect calorimetry and body composition analysis, an enteral nutrition preparation room, a parenteral nutrition compounding pharmacy, a home nutrition support program, and works in close collaboration with oncology, gastroenterology, geriatric medicine, surgery, critical care, and endocrinology through a fully integrated multidisciplinary nutrition team.

Faculty members publish regularly in leading nutrition journals including Clinical Nutrition, JPEN: Journal of Parenteral and Enteral Nutrition, Nutrients, Nutrition, European Journal of Clinical Nutrition, and Asia Pacific Journal of Clinical Nutrition.

Nutritional Assessment

• Nutritional Screening — NRS-2002 for hospitalized patients; MNA for older adults; MUST for community patients; MST for cancer patients; GLIM criteria for malnutrition diagnosis
• Body Composition Analysis — Bioelectrical impedance analysis (BIA); DXA for fat mass, lean mass, and bone density; CT-based muscle mass assessment (L3 skeletal muscle index); phase angle as nutritional status marker
• Metabolic Assessment — Indirect calorimetry for resting energy expenditure (REE) measurement; respiratory quotient (RQ); substrate oxidation; individualized caloric target setting
• Laboratory Assessment — Serum albumin; prealbumin; transferrin; retinol-binding protein; CRP; micronutrient levels (zinc, selenium, copper, vitamins A, D, E, B12, folate); nitrogen balance
• Functional Assessment — Handgrip strength; 6-minute walk test; SPPB; coordination with geriatric medicine and rehabilitation

Enteral Nutrition

Oral Nutritional Supplements (ONS)

• Standard ONS — Polymeric formulas (Ensure, Fresubin, Nutren); high-protein formulas; high-energy formulas; fiber-containing formulas
• Disease-Specific ONS — Diabetic formulas (Glucerna, Diason); renal formulas (Nepro, Renilon); hepatic formulas; pulmonary formulas; oncology-specific formulas (Forticare, ProSure with EPA)
• Immunonutrition — Arginine-enriched formulas (Impact) for peri-operative nutrition; omega-3 fatty acids (EPA/DHA); glutamine; antioxidants

Tube Feeding

• Nasogastric (NG) Feeding — For short-term enteral nutrition; fine-bore feeding tubes; continuous and intermittent feeding; gastric residual volume monitoring
• Nasojejunal (NJ) Feeding — For patients with gastroparesis, pancreatitis, or high aspiration risk; post-pyloric feeding; fluoroscopic and endoscopic placement
• Percutaneous Endoscopic Gastrostomy (PEG) — For long-term enteral nutrition (>4 weeks); head and neck cancer; neurological dysphagia; pull and push techniques; one of China's most experienced PEG programs
• Percutaneous Endoscopic Jejunostomy (PEJ) — For patients requiring post-pyloric feeding; direct PEJ; PEG-J conversion
• Radiological Gastrostomy (RIG) — For patients unsuitable for endoscopic PEG; fluoroscopic guidance
• Feeding Pump Management — Continuous and cyclic feeding; rate titration; formula selection; complication management (diarrhea, aspiration, tube blockage)

Parenteral Nutrition

• Total Parenteral Nutrition (TPN) — For patients with non-functional gastrointestinal tract; short bowel syndrome; high-output fistulas; severe mucositis; individualized macronutrient and micronutrient formulation; all-in-one (AIO) admixtures
• Supplemental Parenteral Nutrition (SPN) — Combined with enteral nutrition when enteral route alone is insufficient; hypocaloric PN; permissive underfeeding in critical illness
• Peripheral Parenteral Nutrition (PPN) — For short-term PN via peripheral vein; low osmolarity formulas; lipid-containing formulas to reduce osmolarity
• Central Venous Access — PICC; tunneled central venous catheter (Hickman, Broviac); implanted port (Port-a-Cath); catheter care and infection prevention
• Home Parenteral Nutrition (HPN) — For patients with permanent intestinal failure (short bowel syndrome, radiation enteritis); one of China's most experienced HPN programs; patient and caregiver training; remote monitoring
• PN Complications Management — Catheter-related bloodstream infection (CRBSI) prevention and management; PN-associated liver disease (PNALD); refeeding syndrome prevention; metabolic monitoring

Oncology Nutrition

Huadong Hospital's oncology nutrition program is one of China's most comprehensive, addressing the nutritional needs of cancer patients throughout the treatment continuum:

• Cancer Cachexia — Multimodal cachexia management; high-protein diet (1.5-2.0g/kg/day); omega-3 fatty acids (EPA 2g/day); anamorelin for cancer anorexia-cachexia; megestrol acetate; corticosteroids for short-term appetite stimulation; resistance exercise; anti-inflammatory strategies
• Peri-operative Nutrition — Pre-operative nutritional optimization (7-14 days ONS or EN for malnourished patients); ERAS (Enhanced Recovery After Surgery) nutritional components; early post-operative enteral feeding; immunonutrition (Impact) for upper GI surgery
• Chemotherapy Nutrition Support — Management of chemotherapy-induced nausea, vomiting, mucositis, and diarrhea; nutritional support during treatment; anti-emetics; glutamine for mucositis prevention
• Radiation Therapy Nutrition — Head and neck radiation: PEG placement before radiation; high-calorie, high-protein diet; mucositis management; pelvic radiation: low-residue diet; probiotics; glutamine
• Immunotherapy Nutrition — Management of immune-related adverse events (irAE) affecting nutrition; colitis; hepatitis; endocrinopathies
• Palliative Nutrition — Goals-of-care discussion; comfort feeding; artificial nutrition in end-of-life care; ethical considerations

Geriatric Nutrition

Huadong Hospital's geriatric nutrition program is uniquely integrated with China's premier geriatric medicine department:

• Malnutrition in Older Adults — MNA assessment; GLIM criteria; oral nutritional supplements; texture-modified diets; fortified foods; appetite stimulants
• Sarcopenia Nutrition — Protein optimization (1.2-1.5g/kg/day); leucine-enriched essential amino acids; HMB (beta-hydroxy-beta-methylbutyrate); vitamin D; omega-3 fatty acids; combined with resistance exercise
• Dysphagia Nutrition — IDDSI texture-modified diet framework; thickened liquids; fortified purees; coordination with speech therapy
• Dementia Nutrition — Finger foods; fortified foods; feeding assistance strategies; PEG decision-making in advanced dementia

Disease-Specific Nutrition

Gastrointestinal Conditions

• Short Bowel Syndrome (SBS) — Intestinal adaptation support; oral rehydration solutions; anti-diarrheal agents; teduglutide (GLP-2 analogue) for SBS-IF; home parenteral nutrition; one of China's most experienced SBS programs
• Inflammatory Bowel Disease — Exclusive enteral nutrition (EEN) for Crohn's disease induction; partial enteral nutrition (PEN) for maintenance; specific carbohydrate diet; low-FODMAP diet; coordination with gastroenterology
• Pancreatitis Nutrition — Early enteral nutrition via nasojejunal tube for severe acute pancreatitis; low-fat diet for chronic pancreatitis; pancreatic enzyme replacement therapy (PERT); fat-soluble vitamin supplementation
• Liver Disease Nutrition — Late evening snack for cirrhosis; BCAA supplementation; zinc supplementation; sodium restriction for ascites; coordination with hepatology

Critical Care Nutrition

• ICU Nutrition — Early enteral nutrition within 24-48 hours; indirect calorimetry-guided caloric targets; permissive underfeeding in early critical illness; high-protein delivery (1.5-2.0g/kg/day); glutamine for burn patients; omega-3 for ARDS; selenium supplementation
• Refeeding Syndrome Prevention — Risk identification; slow caloric advancement; phosphate, potassium, and magnesium monitoring and replacement; thiamine supplementation

Metabolic & Endocrine Nutrition

• Diabetes Nutrition — Medical nutrition therapy (MNT); carbohydrate counting; glycemic index; low-carbohydrate diet; diabetic-specific enteral formulas; coordination with endocrinology
• Obesity — Very low calorie diet (VLCD); low-calorie diet; Mediterranean diet; intermittent fasting; pre- and post-bariatric surgery nutrition; coordination with endocrinology
• Renal Disease Nutrition — Protein restriction for CKD (0.6-0.8g/kg/day); high-protein for dialysis patients (1.2-1.5g/kg/day); phosphate restriction; potassium restriction; renal-specific enteral formulas

Home Nutrition Support

• Home Enteral Nutrition (HEN) — Patient and caregiver training; formula selection; pump management; PEG/PEJ care; remote monitoring; regular follow-up
• Home Parenteral Nutrition (HPN) — One of China's most experienced HPN programs; catheter care training; PN bag preparation; metabolic monitoring; complication management; quality of life support

Why International Patients Choose Huadong Hospital Clinical Nutrition

• China's National Leader — Widely recognized as China's premier clinical nutrition center; founding center of clinical nutrition in China
• Indirect Calorimetry — Individualized caloric target setting based on measured REE; avoids over- and under-feeding
• Teduglutide for SBS — GLP-2 analogue for short bowel syndrome with intestinal failure; reduces PN dependence
• Anamorelin for Cancer Cachexia — Ghrelin receptor agonist for cancer anorexia-cachexia syndrome
• Home PN Expertise — One of China's most experienced home parenteral nutrition programs
• Geriatric Nutrition Integration — Unique seamless integration with China's premier geriatric medicine department
• Cost-Effectiveness — World-class nutritional care at significantly lower cost than equivalent treatment in Western countries

The CMCS Patient Journey

1. Initial Inquiry — Share your medical diagnosis, current nutritional status, weight history, laboratory results, and nutritional concerns with CMCS.
2. Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
3. Specialist Matching — We identify the most appropriate clinical nutritionist based on your needs — oncology nutrition, geriatric nutrition, enteral/parenteral nutrition, or disease-specific nutrition.
4. Nutritional Assessment — We coordinate your comprehensive nutritional assessment including body composition, indirect calorimetry, and laboratory evaluation.
5. Priority Scheduling — We secure appointments with minimal waiting time.
6. Travel & Logistics — Assistance with visa invitation letters, accommodation near Huadong Hospital, and Shanghai airport transfers.
7. Nutrition Plan Implementation — Full coordination of enteral or parenteral nutrition initiation, formula procurement, and device placement.
8. Home Nutrition Follow-Up — Nutrition plan translation, home nutrition support guidance, and remote monitoring coordination after you return home.

Book a Consultation

If you have cancer-related malnutrition, require enteral or parenteral nutrition support, have short bowel syndrome, inflammatory bowel disease, or a complex nutritional condition — CMCS can arrange a specialist consultation with Huadong Hospital's clinical nutrition team in Shanghai.

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